Six CRAZY Months—And more to go to 100% healing!

January, 2015, I started with a new health insurance company, HealthSpan because I wanted to have the opportunity to enroll is some wellness care for weight loss, energy, etc.  The last two trips I took to Israel, it was becoming clearer and clearer to me that I was slowing down physically despite a very happy, busy, involved life. Whatever progress I was making fitness and energy-wise was, over the last year or two, eroding more and more and I couldn’t really “put my finger” on it.  But old and bad habits of assuming it was just all my fault and being a failure at dieting, etc. kept me form really proactively seeking medical advice/help.  But, switching to HealthSpan required a physical by a PCP before referrals to any wellness plans, etc.  Blindly picked a PCP, the first one who could take me and I think by January 9th I had blood work drawn and my first PCP visit with Noha Dardir.  I can’t say I “love” her as my PCP, however, she was thorough and did give me time to discuss some concerns I had with her.  Basically, my bloodwork was good, I was in, according to her, fairly good health…just needed to lose some weight.  I finally spoke up and asked her if someone could look at my heart.  I told her I was 56 years old, that my dad died at 59 of a massive heart attack (and he was not overweight, etc.) and his mother died at an even earlier age of congestive heart failure; I have had a heart murmur since I was about 16 years old (40 years!) and no one has ever really checked it out.  I don’t know what I was asking for/about, and while my cholesterol and triglyceride and sugar numbers were all still “normal”, even if at the high end of normal, she said, “well, ok, we can look at it” and decided to order an echo cardiogram…then changed her mind and said, let’s go ahead and order a stress echo.

February, was the echo study.  The Stress-portion got set up first, i.e. the EKG leads applied, etc. and then the echo tech had me lay down to do the first part of the study.  Her first question “do you find yourself getting out of breath at all” seemed odd to me.  Looking back, I should have been able to answer a very quick YES.  I just didn’t really realize it.  I blamed everything on being fat and out of shape, etc.  I gave no credit at all to some of the accomplishments I had made in these last 4 years, including, even though I’m a turtle, completing several 5K’s and buying my hybrid bike and joining a cycling club.  I had been doing yoga but had stopped that.  Looking back now, I think I stopped it because I kept overheating and feeling poorly afterward. Again, I didn’t connect this to anything but fat/out of shape.  Don’t get me wrong, my weight and physical fitness are a big concern and contribute to much difficulty accomplishing things.  But I never really followed up with anything medically.  Back to the stress-echo!  The tech actually left to go speak with the Cardiologist on duty because she wasn’t sure the stress portion should even continue.  The cardiologist said to go ahead but not to over-stress me too hard.  I still didn’t get real worried or anything.  I just figured she saw my murmur/leak and just wanted to be sure everything was OK.  I aced the stress and just assumed I aced the echo too.  I got called a week or two later by my PCP. She informed me that I had a serious aortic valve leak along with dilating aorta and that I was going to need open heart surgery withing the next weeks/months and that my aortic valve would most likely have to be replaced.

I heard everything she said, and began trying to figure out where/how this was all going to move forward. During the stress-echo I was given a return appointment with the Cardiologist.  Dr. Paul Miller was made Chief of Cardiology at Kaiser Permanente back in the 90’s when I worked there.  He was still there and still Cardiology Chief of HealthSpan, so I requested him.  And my PCP, when she called me, told me I would need to go to University Hospitals to see a Cardio-Thoracic Surgeon.  While waiting for my Cardiologist appointment, I started finding out info about things.  I learned that there were “minimally invasive” procedures possible to some and so looked for a surgeon who had that in his specialty, etc.  Finding Dr. Markowitz early in the process proved to be a blessing.  In hindsight I can tell you that even Cleveland Clinic folks say “he’s the guy” to do aortic valve surgery. And he also has a Professorship at Case Western Reserve University where I work.  So I reached out to him; he was gracious and helpful.  He actually talked to me via phone from his home as well. He asked me to contact him back after my appointment with Dr. Miller and also to get the CD’s from all my studies.  I thought “all my studies, there was just the 1”!!  Well, needless to say, I ended up having LOTS of studies over the next few weeks: a chest x-ray, and while there for they, they noticed I was due for a Mammogram so they did that too; a CT of the chest without and with contracst; a chest MRI without and with contrast because they found a growth/tumor on my paracardiam during the other exams; and then, what was scariest of all to me, a Cardiac catheterization which was performed at Ahuja Medical Center by Dr. Miller.  At first they went in through my right wrist, but the, because they could not negotiate around my heart (I’m in a minority of folks whose particular artery wraps around the back instead of the front–nothing wrong with it, just couldn’t make the “left u-turn” with the catheter to visualize everything. So he then needed to go in through my groin area, where they were quickly able to complete the study.  I was doped up enough that while I remember feeling a bit annoyed that it was taking so long, I wasn’t scared or anything during all this.  It was incredibly quick (by my standards!) the second try.  And, the results were excellent.  My arteries were “wide open and clear”, he told my family in the waiting room that my arteries were “Pristine”!  That was such a good feeling.  Also, the pressure in all my heart chambers were excellent.  The EKG’s had shown excellent electronics in my heart too, so there was this leak…this really bad leak.  He showed me when they shot the dye in how the leak was, and it was all over the place.  But I did not need any bypass surgery due to the pristine arteries.

In the end, after everything, I ended up having a full sternotomy open-heart procedure where I was placed on the heart-lung bypass machine.  Dr. Markowitz had said to me that I needed to not necessarily decide on the procedure because that was “his call” and he would select the best procedure for the best outcomes.  He was firm, but kind and confident but not cocky to where you really understood what he said.  April 23, 2015, about 4 months after the first test results, I became the recipient of a Medtronics Freestyle 25 porcine tissue valve and about 4″ of Dacron aorta decending from it.  My aorta was dilated 4.5 cms or so; 5.0 cms would have meant immediate surgery.  But it wasn’t dilating quickly, so that could have taken longer to detect and I would have felt much worse by that time.  I did very well before, during and after surgery which was on a Thursday, leaving the hospital on my oldest son Michael’s 28th birthday, April 28th!  This pic is of me 48 hours post-surgery!  I felt good enough to let my son snap this pic.  I didn’t feel all that good for much longer!  I still had drain tubes (3) in which were very very uncomfortable, pacer wires in, of course all the other monitoring going on as well, but I had my beloved pitcher of water and a glass of ice which I couldn’t seem to get enough of!  I had my collar pulled up all the way for the visit from my sons.  I didn’t want them to see anything or be uncomfortable about anything.

I will write more on this later, but, as with this entire process, I can only think about it for so long, and then I have to sort of just thing about or do other stuff!